Taking the right approach to aftercare following your pilonidal sinus surgery is extremely important and overlooked.
I experienced little to no aftercare or guidance following my first four surgeries, but that changed after my private surgery with Mr Carapeti.
My personal, 18-month battle against pilonidal sinus disease is why I am now in a position to sit here and tell you all of the best advice when it comes to aftercare.
I experienced an abundance of conflicting advice throughout my entire recovery process, which comes down to the lack of fundamental understanding of pilonidal sinus disease across the UK.
I have also created a series of different help guides with more specific scenarios that can help with your pilonidal sinus recovery, but this page is to highlight the key aspects of aftercare that you can apply, based on my personal experiences.
Note: Please make sure that you consult medical professionals where necessary. This advice about aftercare is from my personal experiences.
Returning Home From Surgery
Once you leave the hospital and return home, don’t try and be a hero! Just rest. It’s as simple as that.
Your body is still going to be reacting to the pilonidal sinus surgery, both physically and mentally.
When you get back home, make sure to stay hydrated and rest in bed. Try to lay on your side and avoid putting any pressure on the open wound. It will be a little uncomfortable to start with, but it will be manageable. Focus on sleeping off the medication and any fatigue you will be feeling.
The First Few Days
The first 72 hours are often the most complicated and the wound (if open), will require regular attention. You will see the most wound exudate occur during the first few days, but then it should start to reduce with each passing day.
Once again, do not try and do anything crazy. Keep resting on your side in bed throughout the day, but do try to get up and walk slowly around the house in regular intervals to promote blood flow around the body and into the wound.
Do not try and go on any long walks. I tried this after one of my surgeries too early on and I found it extremely draining.
We will talk about going to the toilet and diet shortly, but the first couple of times you do go to the toilet post-surgery, you will be constipated. This is due to the pain medication and anaesthesia inside your body.
Drink plenty of water, stay hydrated and eat healthy foods with lots of fibre to combat the impact of this as much as possible. (We will discuss more specifics later on this page).
Showering
Full Guide: Showering After Pilonidal Sinus Surgery
This is a topic that I had conflicting information on for each surgery. At one point I was told to keep the wound dry and not to shower. Another time I was told to shower. It was never a definitive answer.
However, I can tell you that showering is important. I did it every day after my final surgery and made sure to keep the wound as clean as possible.
Note: Remember to remove any wound dressings that are in place before getting into the shower.
The best way to clean the wound in the shower is to take the shower head off the fixed position (if you can) and use your hand to hold the shower head. Gently spray water behind you into the wound to clean inside.
Two key things to note when it comes to showering – Dermol 500 Lotion and digitation:
Dermol 500 Lotion
Dermol 500 Lotion is a moisturising antimicrobial emollient lotion that is used as a soap substitute. This is exactly what I used to clean my open pilonidal sinus wound every day.
It is the best soap substitute to use. This is available to buy in supermarkets, or you can get it on prescription with the NHS.
Digitation
Full Guide: Wound Digitation In Pilonidal Sinus Recovery
Now, this is an extremely important concept that was only explained to me when I had my final surgery with Mr Carapeti. It goes against absolutely everything that I was told on my recovery journey prior.
When I say to ‘digitate your wound’, this means that you need to rub your finger along the wound from top to bottom.
The idea of wound digitation is to prevent the wound from healing too quickly, allowing healthy tissue to formulate from the base of the wound and build up to the top, without a top layer of skin from healing over too quickly.
You may be thinking, “What, I cannot do that!”. Trust me, I had the same reaction. However, it is a lot less scary than it sounds.
I digitated my open wound every single day in the shower. I would get Dermol 500 Lotion on my finger and firmly rub inside the open wound, up and down.
You may experience bleeding for the first few times of digitating, but this is normal. The bleeding will likely stop after a few digitations are carried out.
Note: I did not digitate immediately after surgery due to pain. Listen to your body. After 3-5 days, you should be in a position to physically and mentally start wound digitation. Build up the confidence; you can do it!
Going To The Toilet
Full Guide: Going To The Toilet Following Pilonidal Sinus Surgery
This was one of the most distressing aspects of my pilonidal sinus recovery journey.
I was so anxious about straining and causing stress to the wound.
There were times when I would strain a little too hard and the wound would start bleeding. I would break down when this happened.
However, I want to use my experiences to help you. Here are some key points to take with you:
- Firstly, do not stress! It is inevitable that you will have to slightly strain at some points. The most important thing is to avoid this as much as possible, but again, do not panic.
- Diet is key! Make sure to have a healthy, balanced diet with plentiful fibre.
- Water is so important. I was drinking 2-3 litres of water each day. If you can drink 3 litres of water every day, it will significantly help with staying regular and avoiding constipation.
- I used Water Wipes as a replacement for toilet roll. Avoid wiping directly onto the wound and use water wipes to clean around the area after going to the toilet.
- Wipe down, not up! Make sure to wipe away from the direction of the wound to keep the area as clean as possible.
- If you are able to, shower straight after. Once you have gone to the toilet, go straight into the shower and clean the area and wound. This will reduce the risk of any dirt getting into the wound.
Wound Cleaning & Dressing
Full Guide: Cleaning And Dressing Pilonidal Sinus Wounds
Keeping the wound clean and dressed correctly is very important. You want to do everything you can to reduce the chance of any infection occurring.
We already spoke about how to clean your wound in the shower, but the way you dress your wound can have a huge impact on your recovery.
When it comes to dressing the wound, it is very difficult to do it yourself due to the position and lack of visibility. I was fortunate enough that both my mum and partner were able to do the dressings for me at home, which kept visits to my GP nurse to a minimum.
If you have someone who can do the wound dressing for you at home, I urge you to encourage them to do so! A parent, partner – whoever is around that could provide help during the aftercare process.
In summary, here is what I would do after getting out of the shower as part of the wound cleaning and dressing process:
- Pat the wound dry with gauze pads.
- Wipe out any remaining fluid or water from the wound.
- Pour wound irrigation solution into the wound and place a couple of gauze pads into the wound. Leave to soak for 3-5 minutes.
- Remove gauze pads and pat the wound dry again.
- Using Aquacel Extra wound dressing strips, cut out a portion to match the size of the wound.
- Get your Ortem™ tube and squeeze a line of cream onto the Aquacel strip.
- Place the strip inside the wound.
- Use a Mepore absorbent dressing to place over the top of the wound. If the dressing is not sticking correctly, use medical tape to keep the dressing in place.
This is the exact process I did daily during my most recent recovery. This combined with showering and digitation will promote healing and help you with your pilonidal sinus wound recovery.
As I have mentioned a few specific products that I used, please note that you do not have to use the same. These are products that I recommend based on my personal experience, but the method of dressing should remain the same.
Using Ortem (topical Ointment)
Full Guide: Using Ortem™ For Pilonidal Sinus Recovery
I want to make it abundantly clear that I am in no way endorsed or sponsored by Ortem™ as a wound-healing ointment.
Ortem™ is a proprietary preparation of metronidazole 10% ointment, manufactured by SLA Pharma and available in the UK as an unlicensed medicine.
I was extremely desperate after four failed surgeries; luckily I came across Ortem™ online as it was being used in a clinical trial study for pilonidal sinus wound healing.
I reached out to SLA Pharma, who introduced me to Mr Carapeti and provided me with Ortem™. Mr Carapeti conducted my private (and final) surgery.
Ortem™ is currently available as an unlicensed medicine undergoing a Phase 3 clinical trial. If you think that Ortem™ would be suitable for your treatment, please contact your doctor who can prescribe it on a ‘Specials’ basis. This means that Ortem™ will be charged as a regular prescription.
You could also replace Ortem™ with Flaminal Hydro gel and monitor the progress.
Final Thoughts
As I have mentioned throughout, aftercare is extremely important to recovering from pilonidal sinus surgery.
The information I have provided is based on my personal experiences. I want to provide as much help to others as possible.
I have a lot of specific help guides to discuss topics in greater detail, so make sure to check those out if you need help with other pilonidal sinus related queries.
If you have any questions about pilonidal sinus aftercare, get in touch and I would be happy to help where I can.